Abstract
Kommerell’s diverticulum of an aberrant subclavian artery, which is a rare condition, is a congenital abnormality of the aortic arch. We report a case of Kommerell’s diverticulum of an aberrant left subclavian artery in patient with a right-sided aortic arch. The patient was a 78-year-old man who was diagnosed with a right-sided aortic arch and Kommerell’s diverticulum of an aberrant left subclavian artery. A right renal tumor was detected on follow-up computed tomography, and he was referred to our department. A further examination revealed that he had bilateral renal cell carcinoma (cT1aN0M0). In November 2013, we performed laparoscopic nephrectomy for right renal cell carcinoma and a simultaneous arteriovenous shunt plasty. After the operation, the patient had a bronchial asthmatic attack and developed an acute respiratory disorder and so was admitted to the intensive care unit (ICU). In the ICU, we attempted extubation, and the patient relapsed into dyspnea again. His bronchial asthma started to improve, but he developed respiratory obstruction. Bronchoscopy showed that the Kommerell’s diverticulum had enlarged and compressed both the trachea and esophagus. We confirmed that the patient’s symptoms were caused by his vascular anomaly. We performed capillary hydrodynamic fractionation to reduce the volume load and the mucosal edema in the patient’s respiratory tract. However, he died of severe respiratory failure on postoperative day 18.
